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Clinical manifestations and diagnosis of early pregnancy

Common issues in medical care for reproductive-age women include the diagnosis of pregnancy and the familiarity with normal and abnormal pregnancy findings. The question of whether the pregnant state is at risk for teratogenicity should be addressed. Ultrasonography can also be used to diagnose early pregnancy. Although history and physical examination are not sensitive tools for early diagnosis, knowing the characteristics of a normal pregnancy can alert the clinician to abnormalities such as coexisting disorders or ectopic pregnancy may help.

Any pregnant woman in her first trimester with lower abdominal pain, bleeding or history of an ectopic or impending miscarriage should be evaluated and excluded.

This section will discuss the signs and symptoms and diagnoses of early pregnancy. Ectopic and miscarriage are both non-viable pregnancies. They are discussed separately (see “Pregnancy Loss (miscarriage),: Terminology and risk factors and aetiology” or “Ectopic Pregnancy: Clinical manifestations, diagnosis”). Topic reviews that discuss specific medications during pregnancy are available as well as Lexicomp drug interaction monographs.


End-organ effects of hormonal and mechanical changes can account for most of the clinical findings that are associated with normal pregnancy. These pathophysiologic changes will be described separately.

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Literature review up to Jan 2022. This topic last updated: February 18, 2022.

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